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© 2022 The AuthorsBackground: Recently, an emphasis has been put on anatomical reduction of acromioclavicular (AC) joint both in vertical and hortizontal planes for management of AC joint injuries due to persisting horizontal instability. Therefore, an additional AC fixation in horizontal plane has been recommended. However, relation between horizontal AC joint instability and clinical outcomes is still controversial. This study aims to evaluate outcomes of isolated coraco-clavicular fixation using arthroscopic assisted single coraco-clavicular tunnel technique in grade III and V AC joint injuries and to investigate the correlation between anatomical and clinical outcomes. Methods: This study was conducted with 19 patients with grade III or V AC joint injury. Clinical outcomes included postoperative pain intensity and functional outcomes (Constant Score, American Shoulder and Elbow Surgeons, and Subjective Shoulder Value). Radiological evaluations were performed using radiographs and postoperative computed tomography scans. Degree of initial injury and postoperative stability both on axial and coronal planes were evaluated after radiological assessment. Correlations between anatomical and clinical outcomes were investigated using Pearson\"s correlation test. Results: At the final follow-up assessment, the mean pain score was 1.8 ± 1.8, mean American Shoulder and Elbow Surgeons score was 81.0 ± 15.4, mean Subjective Shoulder Value was 81.3 ± 19.6, and mean Constant Score was 86.3 ± 14.8. The mean loosening ratio and AC distance were 43.5 ± 30.6% and 4.3 ± 12.4 mm, respectively. No correlation was observed between postoperative anatomical and clinical outcomes (P > .05). Conclusion: Additional AC fixation on horizontal plane is not a prerequisite for all injuries, there is no significant association between horizontal instability and clinical outcomes and indications of an additional AC fixation needs to be determined.

Background Here, we compared the clinical and radiographic outcomes between coracoclavicular (CC) fixation with Mersilene tape and hook plate for acute unstable acromioclavicular (AC) joint dislocation treatment. Methods We enrolled 49 patients with unstable acute AC dislocation who, between January 2010 and January 2014, underwent surgery with single CC suture fixation with Mersilene tape (M group, 25 cases) or clavicle hook plate (H group, 24 cases). In M and H groups, the average age was 43.7 (range 18–72) and 42.0 (range 17–84) years, the male to female ratio of each group was 15:20 and 19:5, and the injured side left to right ratio was 12:13 and 11:13, respectively. All patients were right-handed. We retrospectively compared the operation time, complication rate, visual analog scale (VAS), University of California at Los Angeles (UCLA) shoulder rating scale, Oxford shoulder scores, and the radiographic outcomes based on reduction loss of CC distance on postoperative follow-up. Results No significant difference in patient demographics between the two groups in age (p = 0.709), gender (p = 0.217), time from injury to surgery (p = 0.863), and injured side (p = 1.000). The mean follow-up was 26.2 months (range 24–35 months). Nine cases of reduction loss (36%) and one of distal clavicle osteolysis (4%) were noted in the M group. CC distance improvement in the H group was significantly superior to that in the M group at 3 months (before hook plate removal, p

Background Surgical managements are recommended for unstable distal clavicle fractures because of a high incidence of nonunion. A variety of methods have been previously reported, but there is no current consensus regarding which method is the most suitable. Methods Between December 2004 and August 2010, we treated 68 patients with Neer type IIB distal clavicle fractures using single coracoclavicular suture fixation with Mersilene tape (M group) or clavicular hook plate (H group). Sixty-eight patients were followed at least 24 months (mean, 37.9 months). We retrospectively compared the functional outcome, parameters, and perioperative course of the two treatments. Statistical analysis was performed with independent sample t test and chi-square test. Results The M group presented significantly less operation time (P = 0.005) and intra-operative blood loss (P = 0.010) than the H group. The mean University of California at Los Angeles (UCLA) shoulder rating scale, Oxford shoulder score, VAS scale, and satisfaction score revealed no significant difference between the M group and the H group. The M group had better range of motion in the operated shoulder during forward flexion and abduction at 3 and 6 months postoperatively. However, the range of motion at 1 and 2 years after operation revealed almost the same results. Two acromial osteolysis and one acromial fracture were noted in the H group and one superficial wound infection and one frozen shoulder in the M group during follow-up. Finally, there was no significant difference in the complication rate between the two groups, and all fractures achieved union clinically at final follow-up. Conclusions Both single coracoclavicular suture fixation and clavicular hook plate offered effective treatment in acute unstable distal clavicle fractures. However, single coracoclavicular suture fixation with Mersilene tape provided early recovery of shoulder motion and avoided further morbidity of the acromion.